Project Title: Scaling up One health Systems (SOS- rabies): Implementation research for rabies elimination in East Africa
Project Description: Rabies, a fatal zoonotic disease, causes thousands of deaths annually, predominantly in low- and middle- income countries (LMICs). Despite the availability of effective human and animal vaccines, limited access and inequitable distribution hinder global control efforts. The World Health Organization (WHO) launched the "Zero by 30" strategy to eliminate human deaths from dog-mediated rabies by 2030. Gavi, the Vaccine Alliance, recently announced investments in rabies post-exposure prophylaxis (PEP), presenting a critical opportunity for scaling up... Rabies, a fatal zoonotic disease, causes thousands of deaths annually, predominantly in low- and middle- income countries (LMICs). Despite the availability of effective human and animal vaccines, limited access and inequitable distribution hinder global control efforts. The World Health Organization (WHO) launched the "Zero by 30" strategy to eliminate human deaths from dog-mediated rabies by 2030. Gavi, the Vaccine Alliance, recently announced investments in rabies post-exposure prophylaxis (PEP), presenting a critical opportunity for scaling up interventions. This proposal leverages Integrated Bite Case Management (IBCM), a One Health approach recommended by WHO, to guide rabies vaccine rollout and address gaps in human and animal vaccination systems in Tanzania. The study adopts a comprehensive Monitoring, Evaluation, Accountability, and Learning (MEAL) framework, using a developmental evaluation approach to assess the dynamic rollout of PEP and dog vaccination. It consists of three work packages: data analytics and modeling, developmental evaluation, and knowledge mobilization. This participatory research involves iterative co-design with stakeholders, enabling adaptability to real-time challenges and optimizing health systems integration. Objectives 1. Design tools for short- and long-term intervention planning. 2. Develop training materials and guidance for scaling interventions. 3. Evaluate the impact of these interventions as they are rolled out. To meet the above objectives, we will address the following Research Questions: RQ1 - How and why does demand for rabies post-exposure vaccines vary across populations under different policies and control measures? RQ2 - How can robust supply chains be operationalized for post-exposure vaccines given this variation? RQ3 - What training and support is needed to build One Health capacity to deliver interventions (improved PEP access and scaled up dog vaccination) targeting Zero-by-30, the NTD roadmap milestones and universal health coverage (SDG target 3.8)? RQ4 - To what extent does Gavi rollout via Tanzania’s Expanded Program on Immunization (EPI) deliver equitable and effective bite patient management improving access to post-exposure vaccination for those at- risk? RQ5 - What is the reach and coverage achieved and maintained through scaling up dog vaccination? RQ6 - What are the impacts of rolling out improved access to post-exposure vaccines and scaled up dog vaccination? This research supports Tanzania as an early adopter of Gavi’s rabies vaccine program and generates evidence- based recommendations for scaling up rabies elimination interventions in LMICs. It aims to improve equity, health outcomes, and sustainability by informing policy and practice through robust surveillance, adaptive learning, and capacity-building measures.
Principal Investigator : Kennedy Lushasi
Department Name :
Time frame: (2024-09-01) - (2025-08-31)
The University Court of the University of Glasgow (UoG) (Normal)
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